My name is Adam and I am 23 years old. Five years ago I was diagnosed with ADD, severe ocd, depression and the most disabling for extreme anxiety (even though I was diagnosed with these disorders 5 years ago I've been suffering with these problems for pretty much my entire life). Because I had all these problems and I was so unhappy with myself I began smoking marijuana when I was 18. I continued to smoke heavily for about 4 years and quit 7 months ago (I've only smoked 2 times in the past 7 months, I will never smoke again, and I didn't use any other drugs during those 4 years). The problem I am having is that over the past year and a half my anxiety has gotten worst and worst. I can no longer deal with normal day to day things and had to drop out of school. I am extremely isolated and I rarely leave the house. Because of this anxiety and isolation I have become severely depressed and have suffered many panic attacks. I am currently seeing a psychiatrist weekly and taking 3 prescription medications all for anxiety, ocd, and depression including lexapro, neurontin and klonopin. The problem is the therapy and medication is doing very little, I am still extremely anxious and depressed. The worst thing happened to me 2 and 1/2 months ago. I convinced myself I had schizophrenia and went into a severe panic attack that lasted 3 days. Ever since then although the extreme panic has subsided, I feel like I haven't been the same. Its an extremely dull, anxious and hopeless state. It's like I took a drug to alter my mind state and haven't come out of it in 2 and 1/2 months. I am confused and my thoughts are extremely unorganized. I question how to think, act and feel because I have little or no emotional responses to anything. Therefore during deep thinking or conversations I often freeze because I don't know what to think, say or do. I am very indecisive and it feels like I don't know who I am anymore. I also have poor memory and concentration. I was just wondering if my heavy marijuana use caused permanent brain damage and possibly put me into this state. My psychiatrist thinks I went into this state because I am extremely unhappy with myself and trying to find out who I am. However, he admits he doesn't know the long terms effects of marijuana use.

Sorry to hear that you are so screwed up at the moment. It may be of some comfort to you to know that the list of symptoms you describe are extremely common. There are many people feeling just like you, wondering whether they are the only ones who feel as bad, terrified that they are going mad and bogged down in a black world where even making a decision to have butter or jam on toast is a challenge.

You have all of the classic symptoms of profound depression which is often characterised by panic (anxiety) attacks, weight changes, inability to sleep, inability to think, social withdrawal and slowed mental functions.

However, although you say that you feel hopeless you had sufficient motivation to contact this forum and describe, clearly, your problems, which is a very good sign. The style of writing suggests someone of above average intelligence who has been a high achiever in the past, sets high goals for themselves, is a perfectionist and takes failures very personally. Am I right ?

Like many people struggling with their emotions you resorted to a 'prop', marijuana, as a way of blunting your reaction to what was going wrong with your life. This too is common; some people drink instead. There is evidence linking heavy marijuana use with memory loss and schizophrenia, (http://www.thenakedscientists.com/html/shows/2002.04.28.htm) although in relation to the latter, rather like the chicken and the egg, it is not clear whether people with a preponderance to develop schizophrenia are also more likely to abuse drugs, or whether the drugs precipitate the schizophrenia.

It is unlikely that marijuana has caused your problems, since they predate you using it. More likely is that is has exacerbated things.

Since your major problem at the moment seems to be anxiety and panic, why not try a few simple techniques which are often employed to overcome them :

Panic attacks are a learned response. The more you do something, like play tennis or golf, the better you become at it. You have become an expert at panicing ! The situation goes something like this :

A trigger in the environment causes you to recall a memory or thought that you find frightening; the idea that you had schizophrenia for instance. You become anxious and the fight or flight reflex kicks in. Adrenaline pours into your circulation. Your pulse quickens, your breathing becomes more rapid. Your gut switches off and you get that sinking, sick feeling in your stomach as all of the muscles relax. By now you are hyperventilating, whether you realise it or not, and as a result your body is blowing off all of the carbon dioxide in the blood, making the blood alkaline. As a result your fingers tingle, you have a tremor, you can feel your heart thudding and you feel very dizzy (much like being at the top of a mountain). You now focus on all of these symptoms and the thought goes through your head that something terrible is happening to you - a heart attack, a stroke, or maybe you think you're hallucinating and not really experiencing the symptoms. This really makes you panic. Even more adrenaline is pumped into your circulation, making all of the symptoms worse. You panic more. You feel worse...and so it goes on in a repetitive cycle until suddenly it ends minutes to hours later and you literally collapse feeling exhausted for hours afterwards. Sound familiar ?

The key to stopping this is to recognise the triggers that start off an attack, and the symptoms that ensue. When you learn to pre-empt an attack you can take avoiding action.

There are a number of ways to do this. Some people tell themselves "No one ever died of a panic attack. It is just anxiety caused by too much adrenaline in my blood. When the adrenaline levels fall, so will my anxiety. I am not a slave to this and it will go away in a few minutes."

A more interesting approach is to say to yourself "right, I feel a panic attack coming on, so I'm going to try as hard as I can to panic as much as I can !"

This might sound totally counter intuitive but if I say to you "don't think about purple kangaroos" what is the first thing that goes through your mind ? Similarly, when you say to yourself "calm down, don't panic" you do precisely the reverse. Try it.

Depression and anxiety are malignant and pervasive conditions that can wreck your life for a time but which thankfully can be treated. Much of the motivation to get better has to come from you, but if you continually tell yourself to "feel happy, get better, enjoy life", much like the purple kangaroos above, you are actually compounding your misery. Gently getting back into doing practical things with your hands, creative things that can allow you an outlet for your feelings, and giving yourself the time to feel better without pushing yourself are what is required.

There is a fantastic book called Malignant Sadness by Professor Lewis Wolpert from University College London. He describes his depression and how he climbed out of it.

Hi,Thank you very much for your response. I found a lot of the information to be helpful. Especially the example of the purple kangaroo. Trying to force things, like telling yourself to calm down when you begin to panic, or feel better, be happy when you are extremely depressed not only doesn't work, but often makes the problem worse. I also plan on getting the book you recommended, Malignant Sadness by Professor Lewis.I appreciate your time and concern.Thanks again,Adam

Lexapro is an orally administered antidepressant of the selective serotonin reuptake inhibitor (SSRI) class. It has been approved for the treatment of advanced depressive disorder and anxiety; it may also be used for social anxiety disorder, panic disorder or obsessive-compulsive disorder.During the introduction of Lexapro to US market, there have been reports of side reactions appearing upon withdrawal, specialy when the treatment was stopped very quickly. Some of the discontinuation symptoms are: irritability and nervousness, agitation and increased energetic levels - sleep apnea, dizziness, electric shock sensitivity, depression, headaches, sensitivity, and many others. While these effects are in general self-limiting, there have been reports of serious discontinuation symptoms.

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